The public reporting burden for this collection of information is estimated to average 2 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of information. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions for reducing
the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate,
Information Management Division, 4800 Mark Center Drive, East Tower, Suite 02G09, Alexandria,
VA 22350-3100 (0702-0137). Respondents should be aware that, notwithstanding any other provision of law,
no person shall be subject to any penalty for failing to comply with a collection of information if it does
not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR RESPONSE TO THE ABOVE ADDRESS.

Responses should be sent to your local Exchange retail facility,
to the Exchange office whom provided you the application or the update,
or to the Exchange Credit Program at the Army and Air Force Exchange Service,
3911 South Walton Walker Blvd., Dallas, TX 75236-1598.

PRINCIPAL PURPOSES(S): These forms collect personal information mandatory to process and provide the basis of approving
participation in the Exchange Credit Program.

ROUTINE USE(S): Your records may be disclosed outside of DoD pursuant to Title 5 U.S.C. §552a(b)(3) regarding DoD “Blanket
Routine Uses” published at http://dpcld.defense.gov/Privacy/SORNsIndex/BlanketRoutineUses.aspx.
This includes disclosure to the Department of the Treasury, and a debt collection agency with which the United States has contracted for collection
services to recover debts owed to the United States. To any employer (person or entity) that employs the services of others and that pays their
wages or salaries, where the employee owes a delinquent nontax debt to the United States. The term employer includes, but is not limited to,
State and local governments, but does not include any agency of the Federal Government. To consumer reporting agencies pursuant to 5 U.S.C. 552a(b)(12)
as defined in the Fair Credit Reporting Act (14 U.S.C. 1681a(f)) or the Federal Claims Collection Act of 1966 (31 U.S.C. 3701(a)(3)).
The purpose of this disclosure is to aid in the collection of outstanding debts owed to the Federal government; typically to provide
an incentive for debtors to repay delinquent Federal government debts by making these debts part of their credit report. The disclosure
is limited to information necessary to establish the identity of the individual, including name, address, and taxpayer identification number
(Social Security Number); the amount, status, and history of the claim; and the agency or program under which the claim arose for the sole purpose
of allowing the consumer reporting agency to prepare a commercial credit report. This disclosure will be made only after the procedural requirement
of 31 U.S.C. 3711(f) has been followed.

DISCLOSURE: Voluntary, however, failure to provide all the requested information may result in the denial of your application for
inadequate data.

INSTRUCTIONS

Please complete application it in its entirety to ensure timely processing.